Reaction to when things go wrong: comes in time, or a sign to avoid?

Hi All,

I have been an RN for a little over a year now, working in a CTICU. I have already been accepted into a CRNA program to start in 2 years, and with that news comes that point where I am thinking about this career path even harder.

When something goes wrong with my patient, I feel like I have that moment of "oh sh#t" in my head, immediately feel my HR and BP soar, and if it's real bad, my hands get a bit shaky. I am able to take the actions I need to, but I am worried about this response to a crisis. I have read mixed thoughts in the threads here, that it takes time to adjust, and to some extent, this reaction may never completely go away. Others say it is a sign that you will be highly uncomfortable in an anesthesia environment. I have shadowed, but it is tough to place yourself in the provider's exact shoes and truly feel as you may feel if that was you. Looking for advice from those who may have gone through these feelings or know those who did... or who just know their career well - is this normal? Will I adjust, or should I be re-considering this path. Thank you!!!!

Yup, if you still have 2 years until you start you will be fine. It comes with time and exp. I had similar reactions when I was getting ready to apply, by the time I got my app in I was feeling comfortable, and that last year after I got accepted made a huge difference in the way I felt. That uneasiness and panic was gone, you feel like a competent level headed nurse during those situations, and feel prepared for school. One way to improve on this, is to get involved, even if it's not your patient. If there's a patient who is looking like they might go downhill, get involved to find out what has been going on and starting working on figuring out potential causes i.e. diff diagnoses. Start working on that and getting familiar with that process now, so that when the s hits the fan, it will be more like 2nd nature to you. Hope that helps!

Experience will help you feel more confident and proactive in the CTICU. However, you will most likely have residual "mini panic attacks" when you begin as a SRNA due to lack of knowledge and experience, but you can do something in the meantime to make it less so. Make it your goal each shift to look for ways to intervene for your patients. Think about what is the most likely complication to come up during your shift and determine what your action will be ahead of time. Don't hope for a quiet, business-as-usual shift, that's new grad think. Be eager for opportunities to improve your decision making/critical thinking skills. The better you develop these in an environment you are familiar with, the more quickly they will transfer into a new one.